Shot Protects Tiniest

New Vaccine May Save Babies From Bacterial Meningitis

November 15, 2000|By ALISON FREEHLING Daily Press

When Michael Hogge first went to see a doctor, no one was worried. The Hampton toddler had an ear infection and a casse of tonsillities, and he went home with a prescription for antibiotics that seemed to cure him.

But just days later, Michael was in intensive care at Children's Hospital of the King's Daughters, unconscious and on a feeding tube. After spending more than a month at the hospital, he came home on Oct. 18, out of danger but permanently deaf. He still struggles to walk from one end of his house to another, once an easy run.

Michael, 3, is among hundreds of young children stricken every year with a dangerous form of meningitis, or inflammation of the lining of the brain. The infection was brought on by pneumococcal disease, named for a type of bacteria.

"We came so close to losing him," said Pamela Maas, Michael's mother. "At certain points, the only sign of movement - of life - was his chest rising up and down. What this illness can do to a child is so devastating."

Now, doctors are trying to take away the possibility of such a nightmare.

Earlier this year, the Food and Drug Administration approved a new vaccine that protects infants and toddlers from pneumococcal disease, which can lead to life-threatening meningitis and blood poisoning. The vaccine, called Prevnar, is now widely available in Hampton Roads.

This is the first time that such a shot has been offered to children under 2. A vaccine for older children and adults has been available for years and usually is recommended for the elderly and people with certain chronic illnesses.

While some experts don't think enough tests have been done on Prevnar's safety, both the Centers for Disease Control and Prevention and the American Academy of Pediatrics now recommend the vaccine for all children under 2.

The groups also recommend the shot for some children between the ages of 2 and 5, especially those with weakened immune systems.

Pneumococci bacteria live in many people's noses and throats and spread through close physical contact. The bacteria don't often cause serious illness - in fact, many people exposed to them don't get sick at all - but when they do, the results can be severe.

Pneumococcal disease is the leading cause of bacterial meningitis in the United States, according to the CDC. In children under 5, it causes more than 1,400 cases of meningitis a year. In up to half of those cases, children suffer brain damage or hearing loss, and about 10 percent die.

The disease also causes 17,000 blood infections - which also can be fatal - and about five million ear infections in young children.

The Prevnar vaccine is important because children under 2 are at the highest risk for serious disease, said David Holzsager, a Hampton pediatrician. The shot also can reduce the number of ear infections by about 10 percent, Holzsager said.

"This is a very safe shot," he said, "and it might save your child some big problems down the road."

Schools don't require the vaccine, but Holzsager predicts they will in the near future. Preventing pneumococcal infections is especially important now, doctors say, because the bacteria have become resistant to some drugs that once killed them.

Still, not everyone is sold.

Barbara Loe Fisher, co-founder and president of the National Vaccine Information Center, cast the lone negative vote on the FDA committee that studied the vaccine. The NVIC, a nonprofit group based in Vienna, Va., works to prevent vaccine-related health problems.

Fisher said a study submitted to the FDA demonstrated the vaccine's power in fighting serious health problems caused by pneumococcal disease. But she didn't feel the study gave a clear picture of whether the shot could cause serious reactions such as high fever or seizures.

For one thing, Fisher said, the shot often was given with other vaccinations, making it hard to tell which one was responsible for problems.

"I felt we didn't understand the safety picture enough," she said. "I'm not saying that parents shouldn't get this shot. I'm saying they should take the time to get informed about the risks of the disease and what could be the safety issues of the shot, and then decide."

Prevnar is given in four doses over a period of months. Parents might ask to get the shot separately from other vaccines, Fisher said, so if their child had a reaction they could decide not to go ahead with the next dose.

After her son's experience, Pamela Maas is a big fan of Prevnar. Michael recently got the vaccination to protect him from possible future bouts with pneumococcal disease.

A previously healthy child, Michael has slowly improved since leaving CHKD. At first, he had so much trouble with coordination that he couldn't clap his hands. His fine motor skills are about back to normal, and he's walking on his own again.

Michael's hearing is another story. He is deaf in one ear and can pick up just a few low tones in the other. He's learning to lip-read and will need a surgical implant to help him hear.